In the past, when people had signs of strep -- the red, raw throat, spikes in fever, and white spots on the tongue and tonsils -- doctors would culture a specimen from the patient's throat and wait 24 hours to 48 hours for the results. If the test indicated streptococcus, the patient could then start taking antibiotics. To avoid this delay -- in which the infection often grew worse -- most doctors started patients on antibiotics immediately, not waiting for the results of the culture.
Diagnosis has been made much simpler today as a result of the "rapid strep" test. The specimen is obtained just like a culture and involves touching the back of the throat with a small cotton swab to catch some of the germs. The rapid strep test only takes about 15 minutes for results and if the results are positive, the diagnosis is confirmed. However, a negative test does not rule out strep throat since the rapid test may miss some strep throat infections (“false negatives”). These negative tests can be verified by a back-up culture, which is a more sensitive test. The culture results, as in the past, may take up to 48 hours. The beauty of the rapid test is that if it is positive, you can start antibiotics right away without confirmation that the strep organism is the culprit.
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